Mental Health Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Davies of Brixton

Committee stage
Monday 24th February 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to again follow the noble Baroness, Lady Tyler of Enfield, and offer support to her. I will be very brief because there has already been a comprehensive introduction.

It is useful to draw a comparison to see how we might look at some kind of composite as we get towards Report. This amendment places a general duty on integrated care boards to ensure that services in the community have the adequate levels of resource, which is why I signed it, but who gives the resources to the integrated care boards? Ultimately, it is the Government.

My earlier amendment sought a regular process of reports and parliamentary oversight, and I suggest that we need both. This is a good, strong amendment to give the duty to the ICBs. But we also need to see that there is the oversight and that ICBs have the capacity to support the duty they are being given.

[Lord Davies of Brixton (Lab)]

Amendment 157 in my name seeks to clarify the responsibilities of integrated care boards and local health boards to find beds in a timely manner for patients admitted under Section 140 of the Mental Health Act.

This amendment goes to the heart of why we have the Bill in the first place. In large part, the practical problems experienced in obtaining proper care for people led to the introduction of the Bill, Sir Simon Wessely’s review and the work of the Committee. It reflects an important aspect of the transformation that has taken place in the understanding and treatment of mental illness. It reflects the importance of timely and effective care for people experiencing a crisis in their mental health. The Bill seeks to fill in gaps in mental health care, which can mean the difference between rapid intervention and needless delay.

My amendment to Section 140 is both necessary and overdue. It would place a clear responsibility on every integrated care board and local health board to ensure that patients who are assessed as requiring hospital admission under the Act receive it in a timely and appropriate manner. To that end, it mandates a clear line of responsibility by requiring the appointment of a designated officer charged with overseeing that these admission arrangements, as outlined in the Act, are not only established but function effectively on a day-to-day basis. This is not a mere administrative adjustment; it is an important change, aimed at addressing real world issues that affect the lives of countless individuals. Mental health crises occur without warning and do not adhere to schedules or bureaucratic timelines.

The local health boards and integrated care boards are the crucial link between community services and hospital care. Placing a clear statutory duty on these organisations will create a clear line of responsibility to ensure that no patient is left waiting whenever immediate care is needed. The appointment of a designated officer will further enhance accountability and operational efficiency. To emphasise the point, an individual with the specific responsibility of overseeing these arrangements will provide a robust mechanism to promptly address any issues that arise and to ensure that every patient’s admission is swift and appropriate.

It is important to understand the broader implications of this amendment. Timely admission to hospital is not merely a procedural matter; it is a critical component of effective mental health care. Early intervention can mean the difference between a manageable crisis and a catastrophic decline in a patient’s condition. By ensuring that patients are admitted promptly, we will invest in early treatment, reduce the likelihood of complications and, ultimately, alleviate the burden on our healthcare system. This proactive approach will lead to improved outcomes for patients, greater satisfaction among healthcare professionals and a more sustainable model for mental health service delivery.

To conclude, my amendment is a necessary step forward. It would provide clarity, reinforce accountability and ensure that our mental health system remains responsive and effective. I urge my noble friend the Minister to respond positively to my amendment, not merely as a change in policy but as a commitment to the well-being and dignity of every individual who depends on our mental health services.

--- Later in debate ---

[Lord Davies of Brixton (Lab)]

In moving Amendment 135, I am grateful for the support of the noble Baronesses, Lady Tyler of Enfield, Lady Bennett of Manor Castle and Lady Neuberger, and I will be a little disappointed if I do not get some support from the noble Lord, Lord Kamall.

This amendment would require that the established and successful procedure, the mental health crisis breathing space, is offered automatically to those detained under longer-term Sections of the Mental Health Act. This is the final one of a set of three amendments to the Mental Health Bill in my name that have addressed the financial implications for people who struggle with their mental health. In these debates I have previously referenced that I am on the advisory board of the Money and Mental Health Policy Institute. This amendment is based on the institute’s work.

I thank my noble friend the Minister for her engagement on my Amendments 59 and 121, which sought to ensure that routine enquiries on financial matters are embedded in care and treatment plans and advance choice documents. I am grateful for the Minister’s acknowledgement and understanding on these issues.

Amendment 135 calls for mental health crisis breathing space to be automatically offered to those detained under Sections 3, 37, 41 or 47 of the Mental Health Act. Of the three amendments in this set on financial issues, this one perhaps has the greatest scope for reducing the financial harms that people experience when they are facing a mental health crisis. The mental health crisis breathing space mechanism is a vital tool that can protect people in a mental health crisis from the impacts of problem debt by pausing enforcement action and contact from creditors, and freezing interest and charges on any debts. These protections are provided for as long as the treatment lasts—plus another 30 days.

When people access this scheme, it can be life-changing. It can be the difference between people leaving hospital after a mental health crisis to find that bills and debts have escalated, thus putting their recovery in jeopardy, and having the space that they need to get back on their feet. I share the words of one of the Money and Mental Health Policy Institute’s research community members who has personal experience of accessing the scheme:

“Breathing space … has totally changed my experience from feeling hounded and persecuted to supported and valued”,


taking away

“much fear and sleepless nights coupled with dire days of depression”.

However, in its current provision, use of the scheme is significantly below its potential and the numbers that were forecast by the Government. When introducing the scheme in May 2021, the Treasury anticipated that 27,000 people would use it in its first year. Yet the most recent figures from last November show that only 4,404 people have accessed it in total. This underutilisation is due not to a lack of demand or need but to how the scheme is designed and delivered.

Existing NHS guidance on acute in-patient mental health care already states that wards should offer mental health crisis breathing space to those who need it. This is well-intentioned but does little to drive take-up of the scheme. In practice, thousands of people who would benefit from the support of this tool are missing out simply because nobody asks. On top of this, awareness of the mechanism is extremely low among mental health care professionals, meaning that, even when financial difficulties are spotted, it does not always result in people accessing the protections that the mechanism affords.

My proposed addition to the legislation would ensure a statutory obligation to offer this mechanism to those who need it most, requiring services to be more thorough in its implementation, with greater levels of accountability. Specifically, automatically offering the breathing space to people detained for potentially longer-term conditions would ensure that those whose incomes are likely to be adversely impacted by extended admissions can be supported. This intervention would target the core group that the mechanism was intended for.

To outline the possible reach of such a targeted intervention, in 2023-24 there were almost 11,000 detentions under the relevant Sections of the Act, representing a fifth of all detentions. Formalising the automatic offer of mental health crisis breathing space to this targeted group would go a long way towards ensuring that the mechanism supports the number of people that the Treasury forecasted it to serve. Crucially, after the breathing space period has ended, people would have the opportunity to be offered formal debt advice, with specialist support for those who need it, to ensure that financial difficulties are resolved on a longer-term basis. Legislating for the scheme to be automatically offered to those detained under the longer-term provisions of the Act would be genuinely transformative in preventing more people from experiencing the acute financial harms that too often accompany a mental health crisis. I beg to move.

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Davies of Brixton, and to offer the strongest possible support. These are issues that the noble Lord and I—the noble Lord very much in the lead and me following along in support—have engaged with on financial services and markets Bills previously. They are crucial issues for people’s well-being and the well-being of our whole society.

The noble Baroness, Lady Hollins, was talking on the last group about the patient journey. For someone who has become ill, who is seeking treatment and who has the weight of debt sitting on their shoulder, it is worth thinking about how damaging that weight of debt can be to the whole experience of the patient journey. It is worth thinking about how this interacts with issues around discrimination and unequal outcomes that we have looked at regarding other parts of the Bill in terms of the intersectional pressures that people can experience.

In preparing for this, I was looking at the middle of last year and mental health awareness week. The Women’s Institute was focusing particularly on the impact of energy debt, and 14% of the people in the study were at that stage in debt to their energy suppliers. Nearly a third said that they were worrying seriously about this. A fifth said that they had suffered sleepless nights. For the people who are suffering under debt pressures—single parents, very often women, or people from disadvantaged communities that are already economically disadvantaged—all these things feed in together. This is simply a measure for that. “Breathing space” is so evocative of the sense of taking off that pressure and allowing people the chance to focus on their own recovery and their own treatment, rather than just worrying away about that debt. I cannot see why the Government, or why anyone, would oppose this very modest measure.

Education (Assemblies) Bill [HL]

Debate between Baroness Bennett of Manor Castle and Lord Davies of Brixton

2nd reading
Friday 7th February 2025 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to follow the noble Lord, Lord Davies of Brixton. I think the word he used, “charade”, is a description of our current situation. It is worth looking at how, in other debates in your Lordships’ House, we see some very intense discussion about the nature of our schools. We are seeing a lot of debate on mental ill-health among our young people. Having a charade, which is what it very clearly is, at the foundation of this is not good.

I thank the noble Lord, Lord Watson of Invergowrie, for his kind words and apologise to the noble Lord for leaving the Chamber during his speech. If you do three Bills in a row, you have to time the comfort breaks quite carefully; I apologise for that.

As with many people in the debate today, I feel a sense of déjà vu in thanking the noble Baroness, Lady Burt of Solihull, for bringing this Bill, as I thanked her three years ago. The arguments for it now are clearer than ever.

[Lord Davies of Brixton (Lab)]

I apologise; I omitted from my speech my thanks to the noble Baroness. I want to take the opportunity to say thanks again to the noble Baroness, Lady Burt, for bringing this Bill back.

[Baroness Bennett of Manor Castle (GP)]

I am very happy to give way on that basis.

I want to pick up points made by the noble Lord, Lord Weir of Ballyholme. The Bill the noble Lord described does not reflect the Bill I see in front of me. Arguments were made on the question of representing society. But this is not our society any more. Looking at history, I thought it was interesting that the noble Lord spoke about Judaeo-Christianism as a foundation of democracy. I am not sure if the noble Lord knows that some of the earliest democracy that we know of in the world was the old Assyrian empire, well before even the ancient Greeks. To make a claim of exclusivity to democracy does not stack up.

There are three main points I want to make. First, we often hear about how much pressure there is on schools and how much difficulty they have fitting in time for important lessons and activities. Here is a space and time for moral, spiritual and cultural development that we could be using far more creatively and better. As the noble Baroness, Lady Burt, said, the time that is currently theoretically allocated for worship could be used creatively to learn about nature, and for the consideration of ourselves as human animals in a more than human world.

Secondly, we have not made a great deal of this argument today, but it is worth pointing out that the UN Committee on the Rights of the Child has said that the imposition of worship undermines children’s rights under Article 9 of the Human Rights Convention and Article 14 of the UN Convention on the Rights of the Child. As I said in the context of the first Bill I spoke on today, we are seeing the rule of law, human rights and UN traditions under such pressure around the world. That really does help to build the case for this Bill.

A 2024 poll showed that a large majority—70%—of school leaders oppose this collective worship. We have this provision, but we know that it is not being delivered. As the noble Lord, Lord Davies, said, this is a charade. The UK is the only sovereign state where Christian worship is compulsory in state schools, including those without a religious character. We are talking about a law dating back to 1944. It really is time that we moved on and provided care and support for our children.

During this time, a local theatre group could come in and put on a little play that poses a moral conundrum, which could then be discussed. As I said, the time could be used to discuss nature, or there could be lessons in first aid and how to react in situations where it is needed. This time could be well spent on these really useful things—education for life, not exams—and that is what the noble Baroness’s Bill moves towards.

I finish by offering the Green group’s strongest possible support for the Bill, and I very much hope that it progresses.